The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N)

Leana R. Uys, William L. Holzemer, Maureen L. Chirwa, Priscilla S. Dlamini, Minrie Greeff, Thecla W. Kohi, Lucia N. Makoae, Anita L. Stewart, Joseph Mullan, Rene D. Phetlhu, Dean J. Wantland, Kevin L. Durrheim, Yvette P. Cuca, Joanne R. Naidoo

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)


Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n=251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n=244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions.

Original languageEnglish
Pages (from-to)150-159
Number of pages10
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number2
Publication statusPublished - Feb 2009
Externally publishedYes


  • Africa
  • Measurement
  • Nurses
  • Stigma

ASJC Scopus subject areas

  • Health (social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N)'. Together they form a unique fingerprint.

Cite this